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Price: Scientists atSt. JudeChildren’s Research Hospital are working with colleagues in China to develop better therapy for childhood acute lymphoblastic leukemia (ALL). Results from a large phase 3 noninferiority clinical trial definitively showed that vincristine and dexamethasone pulses can be eliminated in patients with low-risk disease. The findings were published today in The Lancet Oncology. Adding the chemotherapy vincristine plus a steroid (originally prednisone, and later dexamethasone) as pulse therapy for childhood ALL has been part of standard care since the 1970s. This is despite their being associated with neuropsychological side effects, neuropathy and other late effects. However, to date studies about the need for prolonged treatment with pulse therapy have been inconclusive. ....
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Chemotherapy drugs can induce mutations that lead to relapse in pediatric ALL patients Chemotherapy has helped make acute lymphoblastic leukemia (ALL) one of the most survivable childhood cancers. Now, researchers working in the U.S., Germany and China have shown how chemotherapy drugs called thiopurines can lead to mutations that set patients up for relapse. The work appears today in the journal Nature Cancer. The research provides the first direct genomic and experimental evidence in pediatric cancer that drug-resistant mutations can be induced by chemotherapy and are not always present at diagnosis. The findings offer a paradigm shift in understanding how drug resistance develops. The results also suggest possible treatment strategies for ALL patients who relapse, including screening to identify those who should avoid additional thiopurine treatment. ....
Corresponding author Ching-Hon Pui, M.D., chair of the St. Jude Department of Oncology, contributed to international research that helps predict and. ....